Individual
MR. ALEXANDER SHILOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
316 BEACH 65TH ST, FAR ROCKAWAY, NY 11692-1425
(718) 474-3800
Mailing address
316 BEACH 65TH ST, FAR ROCKAWAY, NY 11692-1425
(718) 474-3800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
656444
NY
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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